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Individual

MRS. JEANINE KHOURY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4605 MONTICELLO RD, COLUMBIA, SC 29203-4156
(803) 252-7001
(803) 252-5219
Mailing address
4605 MONTICELLO RD, COLUMBIA, SC 29203-4156
(803) 252-7001
(803) 252-5219

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
1215
SC

Other

Enumeration date
07/21/2006
Last updated
03/01/2011
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